Mental Health Inquiry – Time to Get On With It

4 Dec, 2018

The Mental Health Foundation of New Zealand (MHF) welcomes He Ara Oranga, the Mental Health Inquiry’s report to the Minister of Health and is today calling for the Government to get on with making the changes urgently required to transform mental health in New Zealand.

“The Inquiry calls for a number of radical changes, and if they are all put into practice and the voices of the thousands of New Zealanders who participated are honoured, we have a real opportunity to create lasting transformational change,” MHF chief executive Shaun Robinson says.

“We are particularly keen to see work completed urgently on the national suicide prevention strategy as New Zealand has been without one since 2016,” Mr Robinson says. “The government have been waiting for the Inquiry, and the Inquiry has instructed them to stop delaying and get going. There is no further justification for delay, too much time and too many lives have been lost.”

The panel have clearly listened to those who shared their experiences and have now put the responsibility on politicians and the mental health sector to take these stories seriously.

The Foundation urges the public and all stakeholders to take the time to read the report thoroughly and digest its recommendations. It’s a lengthy, nuanced and thoughtful report.

“The Inquiry note that many of their recommendations have been made in the past. Some of these ideas have been written into past strategies and policies, but not implemented and this has been a source of frustration for many. It’s time to stop passing the buck and make a real commitment to improving the mental health and wellbeing of New Zealanders,” Mr Robinson says.

The Foundation believes that delays in implementing past recommendations have had a significant human cost and urges the Government to start acting today.

“We’ve had more than 10 years of neglect and erosion of mental health services and responses,” Mr Robinson says. “There is no more time to waste; it’s time for action.”

The Inquiry is calling for comprehensive reform of New Zealand’s response to mental distress and wellbeing, and their recommendations must be implemented as a whole, not cherry-picked. To create the kind of change we need this Government and all future Governments to be courageous enough to make bold decisions and learn from the mistakes of the past.

“From our perspective, the main barriers to change have been political will, momentum and sustained investment,” Mr Robinson says. “It will be too easy for politicians, government agencies and DHBs to find wiggle room not to really change. We, along with many others, will be keeping the pressure on our political decision-makers to overcome these barriers in implementing the recommendations of this report.”

The Foundation believes that work needs to start urgently to create the new leadership structures recommended by the Inquiry, and increased access to services need to be represented in Budget 2019.

“We will not allow mental health to be neglected any longer,” Mr Robinson says. “No political party can take the moral high-ground here – it’s time to stop trading insults and start working together, across parties, across government agencies and across communities and commit to doing better. Let’s get on with it.”

Highlights:

Many of the recommendations in the report reflect changes the Foundation has long advocated for. The Foundation is particularly pleased to see:

Strong emphasis in the report for a need for a major paradigm shift away from treating psychiatric illness towards supporting people through distress and promoting wellbeing for all.

The representation of a variety of voices – people with lived experience, their whānau and friends, carers, mental health workers and services such as Police. The Foundation welcomes the recommendations requiring lived experience input into decision-making at all levels.

Increased access to a wider range of services for the 20 percent of New Zealanders who will experience mental distress every year, and a focus on strengthening primary health care.

The promotion of structures to lead real change – including the establishment of a Mental Health and Wellbeing Commission, a reshaped social wellbeing agency and a suicide prevention office.

Acknowledgement that Māori mental health is a Treaty of Waitangi issue and that the barriers to wellbeing experienced by Māori, and support for Māori models of health need to be integrated into care. The Foundation strongly supports the establishment of a specific Māori health governance structure and solutions developed by Māori, for Māori.

Recognition of the needs of our Pacific communities and how those needs can be addressed.

Emphasis on culturally-responsive services that take the unique needs of our communities seriously and work to meet those needs.

Promotion of the importance of wellbeing for all people at all stages of life as well as the acknowledgement that many people encounter systemic barriers to achieving wellbeing. We would like to see more thought into how New Zealand can ensure that wellbeing isn’t a privilege accessible only by those with significant means, but achievable for all.

Clear, direct advice to repeal the Mental Health Act and replace it with laws that keep human rights at the forefront.

Disappointments:

The Foundation believes there have been some significant omissions in the report, including:

Lack of a specific recommendation that the response to mental health and addictions be based on a community wellbeing model that includes a range of services and systems outside of healthcare, not a medical model of treating psychiatric illness.

No clear analysis as to why past recommendations and strategies have failed to create change.

Some ambiguity in how recommendations can be interpreted, which leaves room for those reluctant to challenge the status quo to avoid making radical changes.

A lack of focused recommendations about improving the mental health of those who experience the poorest mental health outcomes, including Māori, Pasifika and Rainbow communities. There is no mention at all of Asian communities.

No prioritisation of recommendations, no road map to direct us about where to start and why. All recommendations are equally weighted without acknowledgement that many of them, such as decriminalising drugs, will be extremely difficult to implement.

Recommendations around suicide prevention are not comprehensive or directive, and do not seem to represent the experiences of people who have been suicidal and/or made suicide attempts.

No recommendations that strengthen the roles individuals can play in improving wellbeing, supporting people in distress and preventing suicide.